Provider Demographics
NPI:1275965725
Name:LACHANCE, CATHERINE ODDI (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ODDI
Last Name:LACHANCE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:LYNN
Other - Last Name:ODDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3093 ROCKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-5678
Mailing Address - Country:US
Mailing Address - Phone:912-312-2615
Mailing Address - Fax:
Practice Address - Street 1:1509 ATKINSON RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-7986
Practice Address - Country:US
Practice Address - Phone:770-995-2379
Practice Address - Fax:770-995-2385
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0111122251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics